ABSRACT

Background: HIV infection, a major health problem worldwide, has been reported to be prevalent in patients with acquired anorectal conditions. There is a paucity of published data regarding acquired anorectal conditions in Tanzania, and the study area in particular. This study describes the HIV seroprevalence, clinical patterns and surgical outcomes among patients with acquired anorectal conditions attending surgical clinics at Bugando Medical Centre (BMC) and Sekou Toure referral regional hospital (SRRH).

Methods: This was a cross sectional study that was conducted at Bugando Medical Centre and Sekou Toure regional referral hospital from January 2019 to June 2019 involving 389 patients with acquired anorectal conditions. Data were collected using structured questionnaire. HIV testing was done using standard guidelines and data analysis done using STATA version 13.0 software

Results: A total of 389 patients (M: F ratio = 1.5:1) were studied. Their median age was 42 [IQR 30-54] years. Out of 389 patients, 101 (26.0%) were HIV positive. Of these, 54 (53.5%) were males and 47 (46.5%) were females. Hemorrhoids were the most common acquired anorectal diseases accounting for 198 (50.9%) of cases. The rate of HIV infection in this study was significant higher in patients with perianal ulcers (p-value <0.001), warts (p-value = 0.004), anorectal abscess (p-value = 0.009) and rectal prolapse (p-value < 0.0013. A total of 173 (44.5%) patients underwent surgical treatment for acquired anorectal diseases and the remaining 216 (55.5%) patients were treated conservatively. Hemorrhoidectomy was the most commonly performed surgical procedure. Out of 171 patients who underwent surgical treatment and outcomes evaluated, 138 were treated successfully giving an overall success rate of 80.7%. The success rate was significantly influenced by HIV status (p-value = 0.002). Surgical site infection was the most common postoperative complications accounting for 16/62 (25.8%) of cases.

Conclusion: HIV infection is prevalent 26.0% among patients with acquired anorectal conditions in our setting and has an influence on the surgical outcomes. Hemorrhoids have remained as the most common acquired anorectal conditions. It is recommended that all patients with acquired anorectal conditions attending health facilities in this region should be screened for HIV infection. Also preventive measure measures against HIV infections should be more advocated to reduce new infections and subsequently ensure favorable surgical outcomes.